Waist-to-hip ratio cut-off points for overweight and obesity in Peruvian population

Introduction: Waist-to-hip ratio (WHR) is an anthropometric indicator of obesity that, contrary to BMI, reflects visceral fat. The WHO recommends establishing specific cut-off points for excess weight by country and/or population group. At present, there are no cut-off points for the Peruvian population. Objective: To establish WHR cut-off points to identify overweight and obesity in the Peruvian population. Materials and methods: Cross-sectional analytical study conducted using data from a nationally representative sample of the adult Peruvian population (8 984 men and 11 200 women). An area under the receiver operating characteristic curve (AUC-ROC) analysis was performed to establish the WHR cut-off points for overweight and obesity in men and women according to the presence of overweight and obesity measured using BMI. The strength of the association between WHR cut-off points and BMI cut-off points was assessed using Cramér’s V correlation and calculating the Odds Ratio. Furthermore, the chi-square automatic interaction detection (CHAID) method was employed to determine the WHR values most strongly associated with nutritional status according to BMI in men and women. Results: The AUC-ROC analysis showed that, according to the BMI cut-off points for overweight and obesity, the appropriate WHR cut-off points for overweight and obesity were 0.52 (AUC-ROC: 0.862; p<0.001) and 0.57 (0.934; p<0.001) for men and 0.54 (AUC-ROC: 0.876; p<0.001) and 0.59 (AUC-ROC: 0.933; p<0.001) for women. The association between WHR cut-off points and BMI cut-off points was stronger for obesity in both men (OR=70.46) and women (OR=61.98). Sensitivity for overweight was 87% in men and 91% in women, while these values for obesity were 97% and 96%. Based on the CHAID decision tree, the WHR values most strongly associated with overweight and obesity were 0.580-0.601 and >0.631 in men and 0.579-0.599 and >0.689 in women. Finally, the correlation between BMI and WHR was high in both men and women (Rho=0.843 and 0.861). Conclusions: WHR showed a high correlation with BMI and is a useful tool for identifying excess weight in Peruvian adults. The proposed cut-off points showed good diagnostic performance, with high sensitivity and acceptable specificity.